Please note. The ultimate beneficial owner, must fill in the Client Information sheet. Îáðàòèòå âíèìàíèå. Îñíîâíîé âëàäåëåö ñ÷åòà äîëæåí çàïîëíèòü ôîðìó «Èíôîðìàöèÿ î êëèåíòå» The Client is a: 1. Corporation Êëèåíò: 1. Êîðïîðàöèÿ 2. Partnership 2. Ïàðòíåðñòâî Name in Full: Íàçâàíèå êîìïàíèè: Country of Incorporation or formation of partnership: Ñòðàíà ôîðìèðîâàíèÿ êîðïîðàöèè èëè ïàðòíåðñòâà: Date of Incorporation or formation of partnership: Äàòà ôîðìèðîâàíèÿ êîðïîðàöèè èëè ïàðòíåðñòâà: Business Registration #: Ðåãèñòðàöèîííûé íîìåð: Certificate of Incorporation #: Íîìåð ñåðòèôèêàòà êîðïîðàöèè: Registered office address Àäðåñ ðåãèñòðàöèè êîìïàíèè Steet: Óëèöà: City: Ãîðîä: Province: Îáëàñòü: House: Äîì: App#: Office #: Êâ.: Îôèñ: Country: Ñòðàíà: Zip: Zip: Èíäåêñ: Èíäåêñ: Business office address (if different from Registered Office Address) Àäðåñ ôàêòè÷åñêîãî íàõîæäåíèÿ êîìïàíèè (åñëè îòëè÷àåòñÿ îò àäðåñà ðåãèñòðàöèè) Steet: Óëèöà: City: Ãîðîä: Province: Îáëàñòü: House: Äîì: App#: Office #: Êâ.: Îôèñ: Country: Ñòðàíà: Zip: Zip: Èíäåêñ: Èíäåêñ: Contact information Êîíòàêòíàÿ èíôîðìàöèÿ Telephone (Day): ÒåëåôîíÒåëåôîí (Äåíü): Telephone (Night): Òåëåôîí (Íî÷ü): TelephoneFax (Day): Ôàêñ (Äåíü): E-mailFax (Night): Ôàêñ (Íî÷ü): Corporate E-mail: Êîðïîðàòèâíûé e-mail: Brief description of business Êðàòêîå îïèñàíèå ðîäà äåÿòåëüíîñòè Nature of Business: Õàðàêòåð äåÿòåëüíîñòè: Client Information Statement (Corporation or Partnership) Èíôîðìàöèÿ î êëèåíòå (Êîðïîðàöèÿ èëè Ïàðòíåðñòâî) List of main Shareholders (for Corporation)/Joint Owners or Partners (for Partnership) Ñïèñîê îñíîâíûõ Ó÷ðåäèòåëåé (äëÿ Êîðïîðàöèè)/Ñîâëàäåëüöåâ èëè Ïàðòíåðîâ (äëÿ Ïàðòíåðñòâà) 1 Full name: Ïîëíîå èìÿ: Home address: Äîìàøíèé àäðåñ: 2 Full name: Ïîëíîå èìÿ: Home address: Äîìàøíèé àäðåñ: 3 Full name: Ïîëíîå èìÿ: Home address: Äîìàøíèé àäðåñ: 4 Full name: Ïîëíîå èìÿ: Home address: Äîìàøíèé àäðåñ: 5 Full name: Ïîëíîå èìÿ: Home address: Äîìàøíèé àäðåñ: 6 Full name: Ïîëíîå èìÿ: Home address: Äîìàøíèé àäðåñ: The ultimate beneficial owner of the Account Îñíîâíîé âëàäåëåö ñ÷åòà The person who represents the partnership/corporation in business/financial relations with Broker. The copy of Power of Attorney must be inclosed to this document. Ëèöî, ïðåäñòàâëÿþùåå èíòåðåñû ïàðòíåðñòâà/êîðïîðàöèè ïî äåëîâûì/ôèíàíñîâûì âîïðîñàì ñ áðîêåðîì. Êîïèÿ äîâåðåííîñòè äîëæíà áûòü ïðèëîæåíà ê ýòîìó äîêóìåíòó Full name: Ïîëíîå èìÿ: Signatures (for Corporation) Ïîäïèñàíî (äëÿ Êîðïîðàöèè) Corporate seal: Ïå÷àòü: Full Name of Director duly authorized: Ïîëíîå èìÿ Äèðåêòîðà, èìåþùåãî ïðàâî ïîäïèñè: Signature of Director: Ïîäïèñü äèðåêòîðà: Date: Äàòà: Signatures (for Partnership) Ïîäïèñàíî (äëÿ Ïàðòíåðñòâà) 1 Name of partner: Èìÿ ïàðòíåðà: Signature: Ïîäïèñü: Date: Äàòà: 2 Name of partner: Èìÿ ïàðòíåðà: Signature: Ïîäïèñü: Date: Äàòà: 3 Name of partner: Èìÿ ïàðòíåðà: Signature: Ïîäïèñü: Date: Äàòà: 4 Name of partner: Èìÿ ïàðòíåðà: Signature: Ïîäïèñü: Date: Äàòà: 5 Name of partner: Èìÿ ïàðòíåðà: Signature: Ïîäïèñü: Date: Äàòà: 6 Name of partner: Èìÿ ïàðòíåðà: Signature: Ïîäïèñü: Date: Äàòà: